Affiliation:
1. Department of Textile Engineering, Chemistry and Science North Carolina State University Raleigh North Carolina USA
2. UNC School of Medicine Department of Surgery University of North Carolina Chapel Hill North Carolina USA
3. Montefiore Medical Center Department of Obstetrics & Gynecology & Women's Health Services Montefiore Medical Center Bronx New York USA
4. Joint Department of Biomedical Engineering North Carolina State University & University of North Carolina at Chapel Hill Raleigh North Carolina USA
5. Department of Molecular Biomedical Sciences North Carolina State University Raleigh North Carolina United States
6. College of Textiles, Donghua University Shanghai Songjiang China
Abstract
AbstractPostsurgical adhesions are a common complication of surgical procedures that can lead to postoperative pain, bowel obstruction, infertility, as well as complications with future procedures. Several agents have been developed to prevent adhesion formation, such as barriers, anti‐inflammatory and fibrinolytic agents. The Food and Drug Administration (FDA) has approved the use of physical barrier agents, but they have been associated with conflicting clinical studies and controversy in the clinical utilization of anti‐adhesion barriers. In this review, we summarize the human anatomy of the peritoneum, the pathophysiology of adhesion formation, the current prevention agents, as well as the current research progress on adhesion prevention. The early cellular events starting with injured mesothelial cells and incorporating macrophage response have recently been found to be associated with adhesion formation. This may provide the key component for developing future adhesion prevention methods. The current use of physical barriers to separate tissues, such as Seprafilm®, composed of hyaluronic acid and carboxymethylcellulose, can only reduce the risk of adhesion formation at the end stage. Other anti‐inflammatory or fibrinolytic agents for preventing adhesions have only been studied within the context of current research models, which is limited by the lack of in‐vitro model systems as well as in‐depth study of in‐vivo models to evaluate the efficiency of anti‐adhesion agents. In addition, we explore emerging therapies, such as gene therapy and stem cell‐based approaches, that may offer new strategies for preventing adhesion formation. In conclusion, anti‐adhesion agents represent a promising approach for reducing the burden of adhesion‐related complications in surgical patients. Further research is needed to optimize their use and develop new therapies for this challenging clinical problem.
Funder
National Institutes of Health
North Carolina Textile Foundation
Subject
Pharmaceutical Science,Biomedical Engineering,Biotechnology
Reference130 articles.
1. Abdominal Adhesion Prevention: Still a Sticky Subject
2. Intestinal obstruction from adhesions‐how big is the problem?;Menzies D;Ann R Coll Surg Engl,1990
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献